Lee County’s highest federal shortage score is for dental care. In the shortage-area list the Health Resources and Services Administration (HRSA) updated on Nov. 6, the county’s dental designation scores 20, the highest of any area-based designation in Virginia. That is The Lee Daily Register’s count across the file’s area-based dental designations, which cover 50 counties and cities. Dickenson and Buchanan counties are next at 19 each. HRSA’s data dictionary says a higher score means a higher priority.
The file shows how the score arises. It covers 20,361 residents and counts 1.08 full-time dentists, or one for every 18,853 people. HRSA’s goal for this designation is one per 4,000, which leaves the county 4.01 dentists short. The listing dates to June 1978 and was last updated Sept. 22, 2025.
Three shortage lists, side by side
Lee is on all three of HRSA’s lists. The table below sets its county-wide designations next to the main non-facility designations for Scott and Wise counties. The “short” figure is the number of full-time clinicians the designation says are missing. For primary care and dental we checked it against the file’s own population, goal ratio and clinician count.
| HRSA list (score, who it covers, clinicians short) | Lee | Scott | Wise |
|---|---|---|---|
| Primary care | 15, whole county, 4.04 | 17, low-income residents, 2.27 | 14, low-income residents, 1.93 |
| Dental | 20, whole county, 4.01 | 17, low-income residents, 1.92 | 17, low-income residents, 3.26 |
| Mental health | 18 for all three: one regional designation listed under each county, 77,373 residents, 0 psychiatrists counted, 5.16 short | ||
The scores are not strictly like for like, because Lee’s primary care and dental entries cover the whole county while Scott’s and Wise’s cover low-income residents only. Lee also has facility designations that score higher on some lists, including the St. Charles Health Council health center and the federal prison, USP Lee, at 23 and 24 for dental. Those attach to a specific facility rather than an area.
A report card without a rank
Readers looking for Lee’s place in the County Health Rankings will not find one. Since its 2025 release the program no longer assigns individual ranks. It sorts counties nationwide into ten health groups, where group 1 is the healthiest and group 10 the least healthy, and cautions that the groups do not necessarily mark statistically significant differences.
In the 2025 Virginia workbook, the newest annual release the program’s FAQ describes, Lee is in group 7 for population health and well-being and group 8 for community conditions. Scott is in 6 and 7, and Wise in 7 and 6. Group 8 is the worst one any Virginia locality falls into for community conditions. Lee shares it with Buchanan, Dickenson and Charlotte counties and the cities of Hopewell and Petersburg.
The Register’s comparison table
HRSA, County Health Rankings and the Census Bureau each publish their numbers separately. The table below, our own compilation, puts the rankings workbook’s access measures beside the bureau’s small-area insurance estimates. Those estimates are modeled, and the 2024 data file gives margins of error at 90 percent confidence.
| Measure (data year) | Lee | Scott | Wise | Virginia |
|---|---|---|---|---|
| Residents per primary care physician (2021) | 3,140 | 3,060 | 4,456 | 1,341 |
| Residents per dentist (2022) | 4,396 | 7,159 | 3,542 | 1,329 |
| Residents per mental health provider (2024) | 621 | 649 | 664 | 379 |
| Uninsured under 65 (2024) | 9.7% ±1.2 | 9.1% ±1.1 | 10.1% ±1.1 | 8.1% ±0.3 |
| Preventable hospital stays per 100,000 Medicare enrollees (2022) | 2,805 | 3,912 | 3,412 | 2,505 |
| Fee-for-service Medicare women 65 to 74 with a mammogram (2022) | 41% | 48% | 42% | 46% |
| Life expectancy, years (2020–22) | 71.9 | 73.4 | 70.8 | 77.6 |
Lee has one dentist for every 4,396 residents, 3.3 times as many residents per dentist as the state. The number behind it is five dentists, and Scott’s worse ratio rests on three, so one more or one fewer dentist would change these figures noticeably. Using the workbook’s population of 21,745 and the state’s ratios, we calculate that Lee would have about 16 dentists, 16 primary care physicians and 57 mental health providers, against the 5, 7 and 35 counted. That is illustration, not a federal standard. The two sources count differently, in full-time equivalents versus physicians, so HRSA’s primary care ratio of 7,404 to 1 and the 3,140 to 1 here do not match.
Insurance coverage tells a different story. Applying the standard margin-of-error test ourselves, we find Lee’s 9.7% uninsured is higher than Virginia’s but not distinguishable from Scott’s or Wise’s. It also cannot be told apart from Lee’s 8.9% in the bureau’s 2023 file, because the margins overlap. The estimate equals about 1,454 people under 65.
The table also shows that access is not the whole story. Lee’s preventable-stay rate is numerically lower than Scott’s and Wise’s, yet its life expectancy of 71.9 years is 5.7 years below the state’s. The figures here do not capture travel time or the cost of care. All figures are as of Nov. 6, and HRSA designations can change.
